The Day I Became “The Doctor”

“We need a doctor in here!”

Those words still stop me in my tracks.

The irony is that when I first heard them, I wasn’t a doctor. I was a third-year medical student on my final core rotation: OB/GYN. Graduation was still more than a year away, and I was about as far from feeling ready as anyone could imagine.

“We’d better overhead page for one,” I replied.

It wasn’t a joke. I meant it.

Before I knew what was happening, a couple of labor and delivery nurses had ushered me into the room of a G10P9 who was in active labor.

Labor and Delivery was in complete chaos that day.

One attending and a resident were already scrubbed into a routine cesarean section when another patient developed recurrent fetal heart rate decelerations on the monitor. That routine delivery instantly required an operating room.

Then, only minutes later, the senior OB resident came barreling down the hallway on a stretcher with a hand maintaining elevation of the fetal head.

“Cord prolapse!” she yelled.

With that, the final attending physician standing at the nurses’ station, turned to me, and calmly said, “Can you watch the desk?” as he rushed into the third operating room.

Finally, I thought, a job I was qualified to do.

I was wrong.

Almost immediately another nurse came running toward us.

“We need a doctor in here!”

The nurse looked at me. “I’m not a doctor,” I replied with a trembling voice. “We’d better overhead page for one.”

We paged for any available physician multiple times, but I knew help wasn’t coming. Seconds later I found myself standing at the bedside of a multiparous woman whose baby had clearly decided it wasn’t interested in waiting for anyone’s schedule. A battle-worn L and D nurse looked at me and said, “We’ve got this.”

Before additional help arrived, I had delivered about three-quarters of the baby. An attending rushed in just in time to guide me through the final steps of the delivery and make sure both mother and baby were doing well.

Looking back, I realize how fortunate I was. It could have gone differently. I had excellent nurses, an experienced attending arrived, and what amounted to one of the only straightforward deliveries in the middle of an otherwise impossible day.

But I also remember walking out of that room with a realization that has stayed with me throughout my career. I was built for emergency medicine.

Not because I had expertly delivered a baby. I certainly hadn’t; but I discovered I thrive in moments of uncertainty.

Emergency medicine is filled with situations where no one feels completely ready. We like algorithms, checklists, and protocols because they help us organize chaos. But eventually every emergency physician finds themselves in a situation where there is no one else to call. No specialist is standing outside the door. No either attending is on the way.

You are the doctor.

I’ve always joked that I’m a black cloud. Most emergency physicians know someone who seems to attract pathology like a magnet. If there is a rare complication, an unexpected airway, or a bizarre diagnosis waiting to happen, there’s a decent chance it will happen on my shift.

As new interns or new attendings, you’ll eventually have that moment too.

The nurse will look at you for the answer.

The patient’s family will ask, “What do we do now?”

For perhaps the first time in your career, there won’t be someone standing immediately behind you with the answer. The truth is that none of us ever completely outgrow that feeling.

People sometimes imagine that after residency, or after a decade in practice, these moments become routine. They don’t.

Even as a seasoned attending, some procedures still command your full respect. A resuscitative hysterectomy. A cricothyrotomy. A thoracotomy. These are not procedures that become casual simply because you’ve been practicing longer. Experience brings confidence, but it also brings humility. You understand exactly how much is at stake.

The difference is that experience teaches you something invaluable.

You don’t have to feel comfortable to be capable.

You simply have to keep moving.

Take the next right step. Trust your training. Listen to your team. Accept that fear and competence are not mutually exclusive.

That unexpected delivery as a medical student wasn’t the day I became a doctor. My diploma would come more than a year later, followed by residency and thousands of patients who would teach me far more than any single experience ever could. But it was the first day I understood what emergency medicine would ask of me.

Sometimes the doctor everyone is calling for is you. And even when your heart is pounding, your palms are sweating, and you’re silently wondering whether someone more qualified is about to walk through the door, your patients need you to step forward.

That’s what emergency medicine has always been about. Not the absence of fear. The willingness to answer when someone calls, “We need a doctor in here.”